HIPAA Journal

OCTOBER 7, 2022

On August 5, 2022, Anthem discovered that an unauthorized individual had gained access to a database and downloaded files containing plan members’ protected health information, including names, addresses, dates of birth, phone numbers, email addresses, Medicare ID numbers, and Medicaid ID numbers.

HIPAA 95

HIPAA Health Insurance Medicaid Medicaid 95

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. Download “Compliance Reports You Can’t Live Without” for OIG reporting templates and tips. What Prompts an OIG Inspection?

Fraud 98

Fraud Compliance Medicaid Medicaid 98

MedTrainer

APRIL 11, 2024

Noncompliance: Providers must maintain specific licenses and certifications to provide patient care services. These include a national provider identification number , state licensure, drug enforcement agency license , and state pharmacy license. Get the tools you need to eliminate delays in your provider enrollment process.

Licensing 52

Licensing Medicaid Medicaid Medicare 52

MedTrainer

JANUARY 12, 2024

Here are some of the key organizations involved in regulating healthcare compliance: Centers for Medicare & Medicaid Services (CMS): CMS is a federal agency within the U.S. Department of Health and Human Services responsible for administering and regulating healthcare programs such as Medicare and Medicaid.

Compliance 52

Compliance Fraud Medicaid Medicaid 52

Health Care Law Brief

FEBRUARY 8, 2024

billion to fund Medicaid, $4.8 In addition to the 1115 Waiver, which funds the Medicaid Hospital Global Budget for financially distressed safety net hospitals transitioning from volume-based reimbursement models to value-based models, the HMH Bill would also establish the Healthcare Safety Net Transformation Program (“HSNT Program”).

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

MedTrainer

MARCH 14, 2024

The specialist authenticates the provider’s education, work history, licenses, and other information during provider credentialing. Download Now What are Provider Privileges? Credentialing specialists employed at the healthcare organization or through a contracted credentialing service typically complete this process.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

Verisys

DECEMBER 5, 2023

State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. Here are some examples: Medical schools verify completion of education. Unpublished Data.

Governance 52

Governance Licensing Malpractice Medicaid 52

MedTrainer

MARCH 28, 2024

Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. Clinical & Administrative Departments Adheres to regulations and guidelines within their specific licensing boards and department policies and procedures. Automated escalation speeds up resolution.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

NOVEMBER 17, 2023

Download Now What Does a Credentialing Expert Do in Healthcare? Credentialing teams gather and validate healthcare providers’ qualifications, licenses, and certifications. Secure Document Sharing Platforms: A credentialer needs to know how to navigate document sharing platforms, such as PAVE or state licensing portals.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MAY 4, 2023

This article will focus on the federal changes, but make sure to check with all states where your providers are licensed to stay up-to-date. CMS Burden Reduction Final Rule (84 FR 51732) The Centers for Medicare & Medicaid Services (CMS) permanently extended changes made to the Burden Reduction Final Rule.

Public Health 52

Public Health Compliance COVID-19 COVID-19 Vaccine 52

Verisys

MARCH 1, 2022

State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. Here are some examples: Medical schools verify completion of education. Unpublished Data.

Governance 52

Governance Licensing Malpractice Medicaid 52

Provider Trust

SEPTEMBER 29, 2022

A 49-year-old Brownsville, TX man named Fernando Mendez was taken into custody in early September after being charged with defrauding Medicaid. Mendez, who was a physician assistant at CCI Therapy Counseling Centers International, was working with a suspended medical license. How Often Should You Verify Employee Licenses?

Licensing 52

Licensing Fraud Medicaid Medicaid 52

AIHC

APRIL 25, 2022

Are providers and professionals allowed to download mobile applications to mobile devices? When telehealth is used, it is considered to be rendered at the physical location of the patient, and therefore a provider typically needs to be licensed in the patient’s state. Click Here for Cross-State Licensing information.

HIPAA 52

HIPAA Compliance COVID-19 Compliance Officers 52

Verisys

FEBRUARY 1, 2022

Providers also need an NPI prior to enrolling in Medicare. In July 1993, the Centers for Medicare and Medicaid Services ( CMS ) undertook a project to develop a healthcare provider identification system to meet the needs of the Medicare and Medicaid programs and the needs of a national identification system for all providers.

Fraud 52

Fraud Medicare Medicare HIPAA 52

HIPAA Journal

JANUARY 2, 2023

Downloading PHI onto Unauthorized Devices. Employees need to be aware that there are privacy and security risks associated with downloading ePHI to unauthorized portable electronic devices. Care must also be taken to ensure that the correct patient’s records are released. Are HIPAA violations common?

HIPAA 106

HIPAA Compliance Hospitals Medicare 106

Hall Render

FEBRUARY 4, 2022

Medicare patients win the right to appeal gap in nursing home coverage. Medicare patients win the right to appeal gap in nursing home coverage. Florida’s ACA enrollment is tops nationally, but Medicaid expansion questions remain. Nurse accused of falsifying patient’s COVID-19 test results will keep her license.

COVID-19 40

COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40